Systemtherapie des Mammakarzinoms – Ein Update

Durch die onkologischen Fortschritte der letzten 2 Dekaden ist eine individualisierte Brustkrebstherapie möglich geworden. Mammakarzinome können nicht nur auf der Phänotyp-Ebene durch konventionelle Immunhistochemie charakterisiert, sondern auch anhand molekulargenetischer Analyse in intrinsische Subtypen mit unterschiedlicher Prognose und Therapieansprechen genotypisch klassifiziert werden. In der klinischen Routine werden die unterschiedlichen Subgruppen mittels Immunhistochemie in einer Surrogat-Klassifikation abgebildet. Zur Therapieentscheidung, insbesondere bei luminalen Karzinomen, können Multigenexpressionsanalysen herangezogen werden. Im Kontext personalisierter Therapien werden immer mehr Patientinnen neoadjuvant und mit zielgerichteten Substanzen behandelt. Im Nachfolgenden wird nach neuestem Kenntnisstand auf die Systemtherapie des Mammakarzinoms in der adjuvanten und metastasierten Situation eingegangen.

The oncological advances of the past two decades havs enable individualized therapy for breast cancer. Breast cancers can now be characterized not only at the phenotype level by conventional immunohistochemistry but they can also be classified genotypically into intrinsic subtypes with differing prognoses and therapeutic responses on the basis of molecular genetic analyses. In clinical routine the various different subtypes are represented in a surrogate classification by means of immunohistochemistry. For therapeutic decision making, especially for luminal carcinomas, multigene expression analyses can be employed. In the context of personalized therapy more and more patients can be treated with neoadjuvant and targeted substances. In the present contribution the latest findings in systemic therapy for breast cancer in the adjuvant and metastatic situations are discussed.

Key words

Breast cancer - systemic therapy - target-oriented therapy - targeted therapy - individualized therapy

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